World Neurosurg
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Spinal subdural hematomas (SSDHs) are rare and usually associated with bleeding diatheses, trauma, iatrogenic injury, spinal vascular malformations, or intraspinal tumors. ⋯ In most cases, SSDHs after intracranial surgery resolve with conservative treatment; however, as shown in our case, surgery may be required if there is progressive neurologic decline. Neurosurgeons should be aware of this potential complication after intracranial surgery; a magnetic resonance imaging of the spine may be indicated if there is unexplained lower extremity pain or weakness.
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Stent-assisted coiling technique has been more and more adopted in the treatment of intracranial aneurysms and has been shown to improve long-term angiographic results; however, the treatment is relatively contraindicated in acutely ruptured aneurysms for its ischemic and hemorrhagic complications. Staged stenting after conventional coiling has emerged as a potential treatment strategy for ruptured wide-neck aneurysms. This study assessed the safety and efficacy of coiling in the acute phase followed by delayed stenting for ruptured wide-neck intracranial aneurysms. ⋯ Staged treatment of ruptured wide-neck aneurysms with coiling in the acute phase followed by delayed stenting is safe and effective.
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In patients with supratentorial spontaneous intracerebral hemorrhage, intrahematomal catheter placement may allow for intraclot thrombolysis and drainage. Robotic assistance may be used for the stereotactic placement of catheters. ⋯ Frameless image-guided placement of intraparenchymal hematoma catheter using Robotic Stereotactic Assistance is safe and efficient.
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Trauma accounts for 4.7 million deaths each year, with an estimated 90% of these occurring in low- and middle-income countries (LMICs). Approximately half of trauma-related deaths are caused by central nervous system injury. Because a thorough understanding of traumatic brain injury (TBI) in LMICs is essential to mitigate TBI-related mortality, we established a clinical and radiographic database to characterize TBI in our low-income setting. ⋯ TBI represents a significant part of the global neurosurgical burden of disease. Implementation of proven in-hospital interventions for these patients is critical to attenuate TBI-related morbidity and mortality.
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Case Reports
Acute Bilateral Foot Drop as a Presenting Symptom of Hemorrhagic Synovial Cyst of the Lumbar Spine.
Acute bilateral foot drop is a rare clinical presentation. ⋯ Here, we describe a unique case of a hemorrhagic synovial cyst with a presenting symptom of acute bilateral foot drop.